Peculiarities of COVID-19 coronavirus infection course in patients with comorbid pathology


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Abstract

In the context of the COVID-19 pandemic, patients with chronic diseases could be related to the most vulnerable population groups. The aim of research was to study the incidence and structure of comorbid pathology in patients with extremely severe coronavirus infection course, and to identify the most significant factors determining adverse treatment outcome in comorbid patients with SARS-CoV-2 infection. Material and methods. Survey sample (n=96) was consisted of patients hospitalized with symptoms of COVID-19 infection, aged 21 to 92 years old. The total sample was divided into two groups: the first group consisted of comorbid patients (n=22) aged 21-69 years, the second one - of comorbid patients (n=74) aged 29-92 years. Medical history, demographic parameters (age, sex), data of objective examination, clinical blood test, investigation of C-reactive protein, IL-6 levels, coagulogram (prothrombin time, INR, ACTV, fibrinogen, D-dimer), CT pulmonary scan results on admission and in dynamics, modes of anti-inflammatory and anticoagulant therapy, oxygen support, detected complications, as well as terms of transfer to ICU and treatment outcomes were analyzed. Results and conclusion. In the comorbid patient group, 63 patients died and 11 were discharged with improvement of condition, whereas in the non-comorbid patient group there were 13 deaths among the 22 examined patients. The most frequently diagnosed conditions were hypertension (n=62; 98,4%), obesity (n=32; 50,8%), type 2 diabetes mellitus (n=26; 41,3%), and chronic renal disease (n=25; 39,7%). Patients with comorbidity were found to have a higher mortality rate and were more likely to be transferred to NIVL and ALV than patients without comorbidity. Patients with lethal outcome had more complications and a higher comorbidity index comparatively to those whose hospitalization ended with discharge. Bacterial complications were also more frequent in patients with comorbidity, 63,6% comparatively to 27,3% in patients without comorbidity.

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About the authors

Alexandra S. Sycheva

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia; Clinical medical center of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

assistant at the Department of therapy, clinical pharmacology and emergency medicine, deputy chief physician for outpatient clinical work of the Clinical Medical Center of the University Hospital

Maria A. Malyavina

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

clinical resident of the Department of therapy, clinical pharmacology and emergency medicine

Lyuaza V. Tebueva

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

6th year student

Evgeny D. Grigorievsky

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

neurosurgeon of the clinic for 184 beds

Anastasia L. Kebina

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia; Clinical medical center of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

assistant at the Department of therapy, clinical pharmacology and emergency medicine, deputy chief physician for medical work of the Clinical Medical Center of the University Hospital

Arkady L. Vertkin

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: kafedrakf@mail.ru
Dr. med. habil., professor, head of the Department of therapy, clinical pharmacology and emergency medicine

Alexander A. Solodov

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia; Clinical medical center of A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: docsol@mail.ru
Dr. med. habil., professor of the Department of neurosurgery and neuroreanimation

Igor V. Semenyakin

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Email: dr.semeniakin@gmail.com
Dr. med. habil., associate professor of the Department of urology

Oleg V. Levchenko

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Dr. med. habil., professor, vice-rector for medical work

Oleg O. Yanushevich

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia

Dr. med. habil., professor, academician of RAS, rector

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